Provider Demographics
NPI:1477576619
Name:OHIO INSTITUTE OF CARDIAC CARE, INC.
Entity Type:Organization
Organization Name:OHIO INSTITUTE OF CARDIAC CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SALIM
Authorized Official - Middle Name:O
Authorized Official - Last Name:DAHDAH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-322-1700
Mailing Address - Street 1:1416 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-1923
Mailing Address - Country:US
Mailing Address - Phone:937-322-1700
Mailing Address - Fax:937-322-8070
Practice Address - Street 1:1416 W 1ST ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-1923
Practice Address - Country:US
Practice Address - Phone:937-322-1700
Practice Address - Fax:937-322-8070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0956890Medicaid
OH9253901Medicare PIN